1. Field of the Invention
This invention pertains generally to monitor alarms, and more particularly to a bedside monitor for hospitals.
2. Description of Related Art
Bedside monitors are ubiquitous in acute care units of modern hospitals. However, they are often criticized for generating an excessive number of false positive and false alarms. Frequent false positive alarms not only create annoying distractions but also can cause alarm fatigue for bedside care givers so that attentions to critical alarms are missed raising serious patient safety concerns. Indeed, recent mainstream reports have published cases of avoidable patient deaths that were unfortunately related to the alarm fatigue/desensitization among bedside care givers. Therefore, it is imperative to investigate different strategies to improve patient monitor alarm generation and management.
The issue of false alarms and false positive alarms has been well studied. In a recent report, only 15% of alarms have been found to be clinically relevant in a medical intensive care unit (ICU). In an emergency room setting, it has been reported that only 0.7% of alarms are true positives meaning that they have detected adverse events and led to clinical interventions. Similar findings regarding a high percentage of clinically irrelevant alarms have been reported in diverse ICU environments. False positive alarms can be caused either by false alarms due to noise and artifacts in signals or by inappropriate alarming criteria that are too generic and sensitive. Indeed, most of the threshold-based alarms despite being true alarms are false positives. Extensive research efforts have been put into developing solutions to reduce the false positive rate of monitor alarms. Understandably, the majority of these efforts have been targeted at improving signal processing aspects of alarm generation with the hope that robust signal processing can lead to fewer false alarms. Reducing the false positive rate beyond reducing the number of false alarms is more challenging because of the need for highly sensitive monitoring in an acute care setting.
A direct analysis of alarms has been undertaken in existing studies but the focus has been on annotating individual alarms by trained observers to categorize them into false and true positive alarms. This effort indeed matches the prevailing patient monitoring practice where care givers process alarms one by one as they go off. Little time is available for them to recall historical alarms and then manually associate them with the current alarm to create a more holistic assessment of patients.
Accordingly, an object of the present invention is the ability to account for potential predictive patterns arising from a combination of different single alarms.